Provider Demographics
NPI:1124129432
Name:FRIEDLAND, MELISSA BETH (MD)
Entity type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:BETH
Last Name:FRIEDLAND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2415 MUSGROVE RD
Mailing Address - Street 2:#105
Mailing Address - City:SILVER
Mailing Address - State:MD
Mailing Address - Zip Code:20904
Mailing Address - Country:US
Mailing Address - Phone:301-989-3464
Mailing Address - Fax:310-879-2325
Practice Address - Street 1:2415 MUSGROVE RD
Practice Address - Street 2:#105
Practice Address - City:SILVER
Practice Address - State:MD
Practice Address - Zip Code:20904
Practice Address - Country:US
Practice Address - Phone:301-989-3464
Practice Address - Fax:310-879-2325
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD32923207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD521638204OtherTAX ID
MD08080-1600Medicaid
MD594686Medicare ID - Type Unspecified
MD521638204OtherTAX ID